Living on the Edge — Waiting for a Deal to Avoid the Fiscal Cliff

It’s hard to believe that there’s just a little over three weeks until the new year. And, it’s even harder to believe that Congress and the president still have not reached a deal on how to avoid the fiscal cliff — the automatic spending cuts and tax increases that will occur on Jan. 1, 2013, unless they take action. Since the lame duck session began, there has been little to no movement on a deal.

When I go to Capitol Hill to meet with members of Congress and their staff, I’m not surprised to hear that no one really knows what will happen since there are really only two people who are negotiating — President Obama and Speaker John Boehner, R-OH. Of course, there have been several members on both sides of the aisle who have taken to the airwaves and the talk shows to speak their opinions; however, only the speaker and the president are negotiating in earnest.

There is a saying that “one cannot keep a secret in Washington,” but so far the negotiations between President Obama and Speaker Boehner have been kept relatively quiet with their surrogates trying to garner support amongst the American people for their respective positions. In fact, because so little has been leaked of the details of the negotiations, many believe they could be close to a deal. The optimist in me hopes that they are close to a “grand bargain” that will address the deficit, spending and taxes and will fulfill the wishes of the American people that both sides work together to address this potential economic disaster for our country. But, being in Washington for more than 20 years and witnessing the last decade makes me second guess that optimism.

So, what does this fiscal cliff mean to gastroenterology and why should you care? First, the annual “doc-fix” needs to be addressed — physicians who care for Medicare patients will see a 26.5 percent cut in payments on Jan. 1 unless the issue is addressed. Ironically, you as physicians have been dealing with your own “fiscal cliff” since 2002 and have yet to see a permanent solution to the broken payment system. However, this year, you also face an additional 2 percent across the board cut to Medicare because of sequestration. The additional cut, when tacked onto the 26.5 percent cut, leaves you facing a nearly 30 percent cut in Medicare reimbursement. These cuts would come on top of even more additional cuts, since physician payments under Medicare have not kept pace with inflation for more than a decade and physicians are now required to adhere to an array of quality reporting requirements that could result in additional penalties.

Sequestration will also make deep cuts to federal funding at NIH for medical research. NIH will be cut by 8.5 percent at a time when funding has not kept pace with biomedical research inflation and at a time of great scientific promise. NIH continues to be a smart investment for the federal government, since investments in NIH contribute to economic growth in the life sciences industry and eventually to improved health-care delivery. Cuts to NIH will lead to job losses at a time when our country cannot afford to lose any.

The AGA continues to run our Virtual Advocacy Campaign through which we are asking you to call on Congress to “stop the cuts.” If you haven’t already, please take a few minutes to call your legislator at 1-855-806-2387 to tell them to take action. Don’t have time for a phone call? Visit the AGA website to send an email or letter to your legislator. Watch my video to learn more.

It is very important for members of Congress to hear from you on these critical issues. Many years ago, when I worked on the Hill as a health-care legislative assistant for a member of Congress, he would always ask how many people we had heard from in the district on a particular issue. Your voice truly does make a difference.

Washington may be the only city in the country that has a fiscal cliff countdown clock on every airing of the local news. I am hopeful that the clock will stop ticking well before Jan. 1, 2013.